Individual
MARISA BROOKE AMENT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1883 WISCONSIN AVE, PALM HARBOR, FL 34683-4721
(717) 869-2913
Mailing address
1883 WISCONSIN AVE, PALM HARBOR, FL 34683-4721
(717) 869-2913
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
222Q00000X
Developmental Therapist
—
—
Other
Enumeration date
09/12/2018
Last updated
07/19/2021
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